NSG352 Medication Administration Part 3

Question 1

Intradermal injections site

Answer 1

Just below the dermal/skin layer in the inner/upper arm or the scapula to create a bleb/wheal

Question 2

Intradermal injections use

Answer 2

allergy testing and TB skin testing

Question 3

Intradermal injections needle gauge and length

Answer 3

Gauge: 26-28 gauge
Length: 1/2 inch

Question 4

Intradermal injections angle

Answer 4

5-15 degrees

Question 5

After administration of a TB test, should you touch/rub the injection site?

Answer 5

NO

Question 6

Subcutaneous injection site

Answer 6

Given in the subcutaneous tissue in the upper arm/back/buttocks, abdomen, or thigh

Question 7

Subcutaneous injection use

Answer 7

For insulin and heparin administration

Question 8

Subcutaneous injection needle gauge/length

Answer 8

Gauge: 26-30 gauge
Length: 1/2 to 5/8 inch

Question 9

Subcutaneous injection angle

Answer 9

45-90 degrees

Question 10

What should you do with the skin when administering a subcutaneous injection?

Answer 10

Bunch the skin to stabilize the site as needed; more important for patients with less subcutaneous fat

Question 11

Which site has the fastest absorption with subcutaneous injections? Where is the slowest?

Answer 11

Fastest: abdomen
Slowest: thighs/upper buttocks

Question 12

When giving a subcutaneous injection, what skin types should you avoid?

Answer 12

burns, birthmarks, inflammation, scars

Question 13

Since insulin is given multiple times a day, what should you do to prevent tissue damage?

Answer 13

Change the injection site

Question 14

How long is a vial of insulin good for?

Answer 14

30 days unrefrigerated

Question 15

True/False: Insulin is measured in mL

Answer 15

NO, it is measured in units

Question 16

Why does insulin require an independent double check?

Answer 16

Because it is a high alert medication

Question 17

Because heparin is a __________ it can cause what?

Answer 17

Because it is an anticoagulant it can cause bleeding/bruising.

Question 18

Where should you administer heparin? Why?

Answer 18

• The abdominal sites
• Not near large muscle groups (muscle activity is thought to increase formation of hematomas)
• Avoid 1-2 inches from umbilicus

Question 19

What is unique about administering enoxaparin/lovenox compared to heparin?

Answer 19

• same precautions as heparin administration
• do not remove the bubble of air in the syringe; it is used to “seal” the medication into the deep subcutaneous tissue

Question 20

Intramuscular injection site

Answer 20

The muscle layer beneath the dermis/subcutaneous tissue in the deltoid, rectus femoris/vastus lateralis, or ventrogluteal sites

Question 21

Intramuscular injection use

Answer 21

• Vaccines
• Medications used for pain/nausea
• Antibiotics

Question 22

Medication given IM absorbs more slowly than __________ but more quickly than __________

Answer 22

• IV
• Subcutaneous

Question 23

Intramuscular injection gauge/length

Answer 23

Gauge: 20-25
Length: 1 - 1.5 inches

Question 24

Intramuscular injection angle

Answer 24

90 degrees

Question 25

After administering IM medications, what will increase absorption and alleviate some discomfort?

Answer 25

Rubbing the injection site

Question 26

Describe the Z-Track method and what it is used for. What route is this used for?

Answer 26

- Used for medications that discolor/irritate the subcutaneous tissue - Decreases "tracking" of the medication - Pull the skin 1-1.5 inches to one side of the injection site while injecting the medication and then releasing that traction prior to withdrawing the needle

Question 27

Describe the process of giving an IM injection into the deltoid and what you should be aware of when administering the medication this way

Answer 27

- Use a smaller length needle to not hit the radial nerve/brachial artery - Smaller volumes can be used compared to other sites of injection - Located 2-3 finger breadths below the lower edge of the acromion process then form a triangle with your finger - Insert at a 90 degree angle towards acromion process

Question 28

Describe the process of giving an IM injection into the rectus femoris/vastus lateralis and what you should be aware of when administering the medication this way

Answer 28

- safe to use because it is not near any large blood vessels/nerves - Rapid rates of administration - Rectus femoris is convenient for self injection

Question 29

Describe the process of giving an IM injection into the ventrogluteal site and what you should be aware of when administering the medication this way

Answer 29

- lateral hip is free from major blood vessels, nerves, and fat - insert at 90 degrees angles slightly toward the iliac crest

Question 30

What site is considered the safest/least painful IM injeciton site?

Answer 30

Ventrogluteal site

Question 31

What should you ALWAYS include when documenting injected medications?

Answer 31

The site of the injection